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Patient safety endangered by NHS Trust policy of deliberately delaying ambulances.
An NHS Trust endangered patient safety after implementing a practice of deliberately delaying ambulances. The Daily Telegraph report that Paul Sutton, the chief executive of the South East Coast Ambulance Trust, authorised the delay of ambulances dispatched after people called the NHS 111 helpline to help the trust falsely claim it was hitting key NHS performance targets, improving performance by up to 5%.
The South East Coast Ambulance trust, which covers Sussex, Kent, Surrey and North East Hampshire, implemented its own procedure between 20th December 2014 and 24th February 2015 whereby it downgraded 111 calls, deviating from national standard.
This procedure meant that 20,000 callers – including “life-threatening” cases were told that an ambulance was on its way, when in fact they had been placed in an automatic queue, meaning and given an additional 10 minutes’ clinical triage before an ambulance was dispatched.
Mr Sutton acknowledged in a statement on 29th October 2015 that “the process itself involved clinicians in the EOCs taking additional time to re-triage certain calls coming from 111 to 999,” in order to give themselves more time to respond to urgent calls, to re-assess what type of advice or treatment patients needed and to assess whether an ambulance was really required.
Call handers promising to send an immediate ambulance had no idea their instructions had been over-ruled and it is also alleged that a series of senior staff were pressured into complying with the order.
A separate inquiry examining the extent of harm caused by the policy is due to report later this year. 11 deaths have been linked to the policy so far but thousands of patients are thought to have been affected. The BBC gives the example of a 60-year-old man having his call put in the queue despite suffering clear signs of a cardiac arrest. He died after waiting 35 minutes for an ambulance.
Further investigations will address how this policy was in operation without the trust board’s authority. A detailed review of the project is due to be published in “due course,” according to the BBC.
NHS rules state that calls concerning “Life-threatening” incidents should receive an ambulance response within 8 minutes, whether the caller dials 999 or 111. The NHS recommends that 999 should still be used for life-threatening situations but that:
“You should use the NHS 111 service if you urgently need medical help or advice but it’s not a life-threatening situation.”
The Trust regulator, Monitor, changed the Trust’s governance rating in October due to concerns over the Trust’s “decision-making, governance and approach to patient safety.”
Mr Sutton’s statement seems to only partially address the issues raised the policy: “The pilot was not well implemented and we did not use our own internal governance processes properly to manage it.” It therefore looks as though we will have to wait for the results of the second inquiry to see the full extent of the dangers caused the policy.
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